Meperidine hydrochloride is a potent narcotic analgesic with multiple actions qualitatively similar to those of morphine. The principal actions of therapeutic value are analgesia and sedation.
A 60 mg. to 80 mg. parenteral dose of meperidine hydrochloride is approximately equivalent in analgesic effect to 10 mg. of morphine. The onset of action is slightly more rapid than with morphine, and the duration of action is slightly shorter.
Heretofore, meperidine hydrochloride has been administered both by the oral route and the parenteral (subcutaneous, intramuscular and intravenous) route. However, according to the 1988 Physician's Desk Reference, page 2226, meperidine is significantly less effective by the oral than by the parenteral route, but the exact ratio of oral to parenteral effectiveness is unknown.
U.S. Pat. No. 4,464,378 teaches that morphine and pharmacologically active analogs thereof having at least one aromatic ring, said ring bearing at least one OH group and which are not well absorbed orally, can be delivered via nasal administration and greatly enhance the bioavailability as compared to the oral route.
U.S. Pat. No. 4,464,378 also discloses dosage forms adapted for nasal administration which comprise solutions, suspensions and gels containing a major amount of water in addition to the active ingredient. According to U.S. Pat. No. 4,464,378, nasal dosage forms are preferably isotonic.
However, U.S. Pat. No. 4,464,378 does not disclose or suggest that meperidine and/or its pharmaceutically acceptable salts can be delivered via nasal administration. Additionally, there is no teaching or suggestion that meperidine and/or its pharmaceutically acceptable salts when delivered via nasal administration would have enhanced bioavailability as compared to the oral route.
Some of the major hazards associated with meperidine, as with other narcotic analgesics, are respiratory depression and, to a lesser degree, circulatory depression, respiratory arrest, shock, and cardiac arrest. As such, care must be taken to administer the correct dose of meperidine and to avoid overdosage.
The usual dosage of meperidine for relief of pain is 50 mg. to 150 mg. intramuscularly, subcutaneously or orally, every 3 or 4 hours as necessary. However, as noted above, meperidine is less effective by the oral route than the parenteral route.